This invention relates generally to tracheotomy associated equipment and more particularly concerns flexible connectors for coupling in-line catheters to tracheotomy tube inner cannulas.
In-line suction catheters are used to permit a patient to continuously respirate through a tracheotomy tube while the catheter is inserted into the inner cannula of the tracheotomy tube. The in-line catheter has a housing with two inlet ports and an outlet port. A ventilator circuit is connected to one of the housing inlet ports. The catheter extends into the housing through the other housing inlet port. A flexible connector couples the housing outlet port in serial communication with the inlet or ventilator end of the inner cannula. The air and catheter are pushed through the flexible connector into the inlet end of the cannula for administration to the patient. The flexible connector consists of an accordion-like tubular body with entry and exit collars on its respective ends taken in relation to the direction of insertion of the catheter. The exit end of the flexible connector slips onto the entry end of the inner cannula and the entry end of the flexible connector slips into the outlet port of the in-line catheter housing.
In-line suction catheters, as they are inserted through known flexible connectors into the entry end of the inner cannula, almost always hang up on the inlet face of the insertion end of the cannula. This interference necessitates immediate implementation of one or more remedial actions until the problem is resolved. Initially, the flexible connector is longitudinally compressed to decrease the length between the tip of the in line suction catheter and the ventilator end of inner cannula. If compression does not resolve the problem, the suction catheter is twisted and turned in an attempt to “flip” it into the entry to the inner cannula. These actions cause discomfort to the patient, lengthen the time required for completion of the procedure, waste the valuable time of respiratory therapists and nurses and expend possibly precious time for the patient undergoing the procedure.
If neither compression nor “flipping” are successful, the inline suction catheter is eventually disconnected from the ventilator circuit. In this case, the procedure is further lengthened by the extra time to needed to disconnect and reassemble the ventilator circuit. More significantly, disconnection causes a loss of ventilator pressure to the patient which can be rapidly physiologically catastrophic, cause a loss of sterility possibly resulting in more infections and further subject the patient to more stressful discomfort including the experience of a “smothering” feeling from no longer being on the ventilator. Furthermore, some patients require the pressure created by the ventilator circuit to keep their airways free of fluid and allow oxygenation/ventilation to occur. Once pressure is lost, the procedure has embarked on down hill course. A disconnect from the pressure of the ventilator circuit can result in rapid “flooding” of the alveoli with fluid, resulting in extremely quick decompensation, perhaps in as little as the time for eight breaths. When the ventilator circuit is reconnected, it can take several hours for the regained pressure to clear the alveoli of fluid. For patients who are dependent on maintenance of continued pressure, it is imperative that no disconnects occur as the benefits of loss of pressure are quickly lost and slowly regained.
In a worst case scenario, once the connector has been removed and the in-line suction catheter has been placed directly on the inner cannula, the catheter may still hang up on the cannula entry face. In this event, it is necessary to acquire from supply and install a different type of suction catheter which can be passed directly into the inner cannula entry, leaving the patient completely off the ventilator and increasing the time and expense of the procedure and the risks and discomfort to the patient.
It is, therefore, an object of this invention to provide a flexible connector which facilitates easy passage of an inline suction catheter into a tracheotomy tube inner cannula. Another object of this invention is to provide a flexible connector which does not require longitudinal compression to accomplish passage of an inline suction catheter into a tracheotomy tube inner cannula. A further object of this invention is to provide a flexible connector which, even when arcuately flexed, will readily pass an inline suction catheter into a tracheotomy tube inner cannula. Yet another object of this invention is to provide a flexible connector which does not require twisting and turning of the suction catheter to “flip” the catheter into the inner cannula. It is also an object of this invention to provide a flexible connector which reduces the likelihood of need to disconnect the patient from the ventilator to accomplish passage of a catheter into a tracheotomy tube inner cannula.